At what age should I consider having cosmetic surgery enhancements?
Our patients range from people in their early 20’s to those that are 65 years of age and beyond. Women in their early 20’s want to start maintenance programs, including collagen for fuller lips. People in their 30’s often choose BOTOX TM or other injectable fillers to reduce fine lines and facial folds. Mini facelifts are available for those in their 40's who don't need a traditional full facelift, but want to tighten up the sagging skin and underlying muscles below the eyes and above the mouth, with little down time away from work. Men and women in their early 50’s and 60’s, who are looking for a more youthful and dramatic enhancement can achieve it with an array of cosmetic surgery options.

If I begin with a nonsurgical cosmetic procedure, what is available and should I do anything in advance to prepare for them?
There are many nonsurgical or minimally invasive options available for facial rejuvenation. Fillers such as collagen, Restylane and others are helpful to plump up lines in the face or to enhance the lips. BOTOX is useful for erasing wrinkles in the forehead, crow’s feet and frown lines between the eyes. There is little preparation necessary for injection therapy. Depending on the preparation of collagen used a skin test may be necessary prior to injection. The preparation for chemical peels and laser resurfacing will differ and the specifics of each procedure will be discussed with you during the consultation appointment.

People tell me I always look tired. Will cosmetic surgery help?
There are several areas to address for that tired look. First, decide which area is of the greatest concern to you.

Eyes: Procedures that can make an impact on the eyes include endo-brow lift, blepharoplasty or eyelid lift, peri-ocular laser resurfacing, chemical peels and BOTOX injections.

Lips: Cosmetic Fillers such as EVOLENCE®, Restylane™, Juvederm™ and Radiesse™, peri-oral laser resurfacing and chemical peels can smooth out lines and wrinkles around the mouth area.

Then talk with your surgeon about the results you expect and the costs involved.

Why should I choose a facial plastic surgeon for cosmetic surgery?
A facial plastic surgeon is board certified by the American Board of Facial Plastic and Reconstructive Surgery (ABFPRS). This specialist has had one year of general surgery residency, followed by four years of residency in Otolaryngology (ENT) and one year specialty fellowship in Facial Plastic Surgery. The board certified facial plastic surgeon has had a two-day board exam and must submit 100 surgical cases for review by his medical peers.

What kind of training have your facial plastic surgeons completed?
Dr. Branham completed his residency in Otolaryngology - Head and Neck Surgery at St. Louis University and his Facial Plastic Surgery fellowship at Washington University School of Medicine, St. Louis, Missouri. He is board-certified in Facial Plastic and Reconstructive surgery as well as Otolaryngology. He has been in practice more than 22 years in the St. Louis area and has been named as a Best Doctor in AmericaTM and included in the list of America's Top DoctorsTM every year, from 2002 through 2010.

Will people know I had cosmetic surgery?
People will notice a change, but they usually cannot pinpoint what is different. Statements frequently heard include: “Did you just get back from a vacation?” “You look great.” “Have you lost weight?” Whether others notice will depend on what type of surgery you have performed and the perceptiveness of the observer.

Is facial cosmetic surgery the same for men as it is for women?
Cosmetic procedures for men and women, such as eyelid surgery (blepharoplasty), nose surgery (rhinoplasty) and facial implant surgery are performed essentially the same way. Special considerations are made for men due to beard growth and pattern, sideburns and receding hairlines that need to be evaluated. There are also other differences that include thicker facial skin and a richer blood supply to the face that are typical in most men. Scarring may be more difficult for men to hide, since they don’t wear makeup or style their hair toward their faces as many women do. In general, men prefer a more angular and chiseled overall look to their facial features in contrast to the softer, rounder look of the female profile. Dr. Branham and Dr. Chi will evaluate your unique features and discuss the right approach for you at the initial consultation appointment.

How long do the effects last from cosmetic surgery?
There are many factors that determine how long the effects last including sun exposure, weight gain or loss, and the muscle and bone structure of your face. You will continue to age, but the changes made with surgery have a lasting effect.

Is cosmetic surgery very painful?
Each person differs in how he or she tolerates postoperative pain. Depending upon the extent of surgery, the first 24 to 48 hours are the most uncomfortable for patients. Appropriate pain medications are available for postoperative patients. For the remaining recovery period, Tylenol is generally adequate for controlling any discomfort. Most patients say that the symptoms following surgery are more bothersome than painful.

How long will I need to recover from cosmetic surgery?
Recovery time from surgery is normally one to two weeks, depending on the extent of the surgery performed. Other factors to consider are the type of work that you do and how tolerant you and your employer are to swelling or bruising. Most patients have sutures removed after one week and are ready to resume normal activities.

How much scarring will be caused by cosmetic surgery?
Any incisional surgery will leave scars. To ensure that scarring is kept to a minimum, incision placement is as inconspicuous as allowable. Once you have healed, scars are generally not visible. Make-up will help diminish any remaining pinkness of skin when you return to work. . There are some newer minimally invasive surgical techniques performed laparoscopically (or through small incisions) that may be an option for you. During your evaluation, these options can be discussed.

How much does facial plastic surgery cost?
The physician fee is dependent on the procedure(s) performed. In addition, there are facility and anesthesia fees. These costs are based on time and usage; in order to give you an accurate estimate please call for a consultation.

How do I make a consultation appointment?
Appointments can be made by calling our office at (314) 996-3880. You may also contact us by email at facialplasticsurgery@ent.wustl.edu for information on seminars offered throughout the year or to answer general questions. Please refer to our Privacy Policy for the types of questions that can be answered by our office through email.

Does health insurance cover cosmetic surgery for the face?
Cosmetic facial surgery is not covered by health insurance. If the surgery corrects a medical problem then health insurance may cover some of the cost. Our office will consult your health insurance to determine coverage and authorization.